Antiangiogene Therapie gastrointestinaler Tumoren

Zusammenfassung

Für die gastroenterologische Onkologie werden auf neuartigen Mechanismen basierende Therapiestrategien benötigt, die insbesondere keine Kreuzresistenzen mit den gegenwärtigen Standardtherapien zeigen. Einen solchen Ansatz stellt die therapeutisch intendierte Antiangiogenese dar, bei der zielgerichtet die Gefäßversorgung solider Tumoren inhibiert wird. Da sich zahlreiche gastrointestinale Tumoren durch eine ausgeprägte Neoangiogenese mit einer daraus resultierenden Hypervaskularisation auszeichnen, werden antiangiogene Therapieansätze künftig eine Schlüsselrolle in der gastroenterologischen Onkologie einnehmen. Entsprechend werden in dieser Übersichtsarbeit (i) grundlegende Mechanismen der Tumorangiogenese, (ii) aktuelle antiangiogene Interventionsansätze auf dem Gebiet der gastroenterologischen Onkologie sowie (iii) gegenwärtige Limitationen und Perspektiven dieser neuartigen Therapiestrategie dargestellt.

Abstract

New therapeutic strategies that notably lack cross resistance with established treatment regimens are much needed in gastroenterological oncology. One such approach is therapeutic anti-angiogenesis which aims at the inhibition of vasculature growth in solid tumours. Since numerous gastrointestinal tumours show strong tumour neoangiogenesis and consequently are highly vascularised, anti-angiogenic therapies will play a pivotal role in tomorrow’s gastroenterological oncology. Hence, this review covers (i) basic mechanisms of tumour angiogenesis, (ii) recent anti-angiogenic strategies in the field of gastroenterological oncology as well as (iii) a discussion of their current limitations and perspectives.

Schlüsselwörter

Tumorangiogenese - Antiangiogenese - antiangiogene Therapie - VEGF - Bevacizumab - gastroenterologische Tumortherapie

Key words

Tumour angiogenesis - anti-angiogenesis - anti-angiogenic therapy - VEGF - bevacizumab - gastrointestinal tumour therapy

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1 http://www.boerse-online.de/v4/aktien/usa_asien/art/ac/262773.html

2 http://clinicaltrials.gov/ct/search?term=bevacizumab&submit=Search (NIH)

3 http://www.ecog.org/general/active_prot.html (ECOG)

4 http://www.eortc.be/protoc/ (EORTC)

5 http://www.studien.de/

6 http://www.regeneron.com/company/tarrytown.asp (Fa. Regeneron)

7 http://www.schering.de/scripts/de/30_rd/pipe/onco/conf12.php (Fa. Schering)